The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Kenjiro Kohri - One of the best experts on this subject based on the ideXlab platform.
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ventral based Dartos flap for the prevention of the urethrocutaneous fistula urethroplasty
International Journal of Urology, 2007Co-Authors: Yutaro Hayashi, Yoshiyuki Kojima, Akihiro Nakane, Satoshi Kurokawa, Keiichi Tozawa, Kenjiro KohriAbstract:Background: Urethrocutaneous fistula is a common complication of urethroplasty for hypospadias even when a microsurgical technique is applied. Methods: From January 1999 to November 2006, we applied the ventral based Dartos flap wrapping technique to prevent the occurrence of urethrocutaneous fistula in 34 patients with hypospadias. Results: Hypospadias was repaired without fistula formation in 31 patients while three patients developed a tiny fistula, which was later closed successfully by a simple procedure. Conclusion: We conclude that the ventral based Dartos flap wrapping technique could be an alternative to the dorsal Dartos flap for covering the neourethra with a vascularized flap because the procedure is very simple, and complications rarely occur.
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scrotal Dartos flap for the prevention of the urethrocutaneous fistula on hypospadias urethroplasty
International Journal of Urology, 2005Co-Authors: Yutaro Hayashi, Yoshiyuki Kojima, Akihiro Nakane, Satoshi Kurokawa, Kentaro Mizuno, Kenjiro KohriAbstract:Abstract Background: Urethrocutaneous fistula is a common complication of urethroplasty for severe hypospadias, even when a microsurgical technique is applied. Patients and methods: From June 2001 to July 2003, we applied the scrotal Dartos flap wrapping technique to prevent the occurrence of urethrocutaneous fistula in 14 patients with hypospadias. Results: Hypospadias was repaired without fistula formation in all but one patient, who developed a tiny fistula which was later closed successfully by a simple procedure. Conclusions: We recommend the scrotal Dartos wrapping technique for covering the neourethra with a well-vascularized flap because of fewer complications, although the procedure to obtain the vascularized flap may take longer.
Peter D Furness - One of the best experts on this subject based on the ideXlab platform.
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successful hypospadias repair with ventral based vascular Dartos pedicle for urethral coverage
The Journal of Urology, 2003Co-Authors: Peter D FurnessAbstract:ABSTRACTPurpose: We describe an easy technique to reliably harvest a vascularized Dartos pedicle for urethral coverage at the time of urethroplasty in hypospadias surgery. The complication of urethrocutaneous fistula in hypospadias surgery as a result of using this technique is also evaluated.Materials and Methods: A retrospective review (July 1999 to September 2002) identified 180 pediatric patients who had undergone primary hypospadias surgery by a single surgeon. A modified technique of harvesting a vascularized Dartos pedicle was incorporated in 111 hypospadias repairs. A ventral based vascularized Dartos pedicle of tissue was used to cover a modified urethroplasty as described by Snodgrass.Results: The intraoperative meatal position before urethroplasty was subcoronal in 95 cases, penile/midshaft in 11 and penoscrotal in 5. The majority of patients (90 of 111) were younger than 12 months at surgery. Ages ranged from 5 months to 16 years (mean 21.1 months). Of the 111 patients reconstruction using the...
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snodgrass hypospadias repair with vascularized Dartos flap the perfect repair for virgin cases of hypospadias
The Journal of Urology, 2002Co-Authors: Earl Y Cheng, Peter D Furness, Sreenivas Vemulapalli, Bradley P Kropp, John C Pope, William E Kaplan, Preston D SmithAbstract:ABSTRACTPurpose: Since its introduction, the Snodgrass hypospadias repair has been applied to virtually all forms of hypospadias repair. However, fistula rates have still been reported to be as high as 5% from large center, multiple surgeon studies and 16% from smaller center studies. We report on the use of the Snodgrass repair in conjunction with routine use of a vascularized Dartos flap and 2-layer closure of the neourethra from multiple institutions.Materials and Methods: Records of patients who underwent a primary 1-stage hypospadias repair with the Snodgrass technique in conjunction with vascularized Dartos flap coverage were reviewed. Nearly identical surgical technique was used by all 6 surgeons in each case, which included a 2-layer closure of the neourethra, preservation of the well vascularized periurethral tissue and routine use of vascularized Dartos flap coverage. A total of 514 cases were identified, including 414 with distal and 100 with midshaft or proximal hypospadias. Stents were used i...
Baher A Kamal - One of the best experts on this subject based on the ideXlab platform.
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double Dartos flaps in tubularized incised plate hypospadias repair
Urology, 2005Co-Authors: Baher A KamalAbstract:Abstract Objectives To compare the single Dartos flap with double Dartos flap coverage. Two overlapping layers of Dartos flap were fashioned and fixed in front of the neourethra after tubularized incised plate hypospadias repair to prevent urethrocutaneous fistula and glanular torsion. Methods A total of 96 boys with distal hypospadias were treated with tubularized incised plate urethroplasty. They were divided into two groups. Group 1 (54 patients) had a single Dartos flap covering. Group 2 (42 patients) had double Dartos flap coverings. The dissected dorsal Dartos flap was bisected vertically to form two pedicled wings. Each wing was rotated laterally from either side of the glans to cover the neourethra ventrally in a double-layer fashion. Results In group 1, 2 patients (3.7%) developed fistula, 49 (90.7%) had mild glanular torsion, and 5 (9.3%) had moderate glanular torsion. None of group 2 developed fistula or glanular torsion postoperatively. Conclusions Double Dartos flaps covering of the neourethra is a simple procedure that was superior to single flap covering for the prevention of urethrocutaneous fistula after tubularized incised plate urethroplasty. Glanular torsion did not occur when double Dartos flaps were used.
John M Park - One of the best experts on this subject based on the ideXlab platform.
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penile torsion repair using dorsal Dartos flap rotation
The Journal of Urology, 2004Co-Authors: Peter C Fisher, John M ParkAbstract:ABSTRACTPurpose: Counterclockwise penile torsion is a frequently noted congenital deformity. Previously proposed techniques of torsion repair are ineffective or pose significant operative risks. We introduce a novel technique using dorsal Dartos flap rotation.Materials and Methods: The penis is first degloved completely and a broad based Dartos flap is mobilized from the dorsal penile skin. The flap is rotated around the right side of the penile shaft and attached to the ventral aspect, causing clockwise penile rotation. Final slight adjustments are made during skin closure. We applied this technique in 8 patients undergoing circumcision (2), chordee (4) or hypospadias (2) repair.Results: This technique was effective for correcting penile torsion in all patients. At a mean followup of 8.3 months the cosmetic outcome was satisfactory with the complete correction of penile torsion.Conclusions: Rotational repositioning of a dorsal Dartos flap is an effective technique for correcting penile torsion and it is ...
Tapas Majhi - One of the best experts on this subject based on the ideXlab platform.
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comparative study of Dartos fascia and tunica vaginalis pedicle wrap for the tubularized incised plate in primary hypospadias repair
The Journal of Urology, 2006Co-Authors: Uday S Chatterjee, Manas K Mandal, Supriyo Basu, Ranjit Kumar Das, Tapas MajhiAbstract:OBJECTIVES To report a prospective comparative study on using Dartos fascia, i.e. subcutaneous tissue of penile skin and tunica vaginalis pedicled wrap (TVPW) from the parietal layer of the tunica vaginalis of the testis, for a one-stage tubularized incised-plate (TIP) repair for hypospadias. PATIENTS AND METHODS Forty-nine patients (mean age 4.6 years, range 1–22) with hypospadias of different types (varying from coronal to penoscrotal) were repaired in one of three hospitals over 3 years. All patients were repaired using the TIP technique, with Dartos fascia wrap used in 20 and TVPW in 29, without using a loupe or microscope during surgery. Urinary diversion and splinting were provided by a urethral catheter. The operative duration for both groups was similar at ≈ 2 h. RESULTS In the Dartos fascia group there were three (15%) fistulae, but there were none in the TVPW group. CONCLUSIONS Although the dissection for TVPW seems to be cumbersome theoretically, it is not difficult. The combination of TIP and TVPW in primary repair may be a good alternative to other techniques.
